During the Middle Ages of the plague
we got sick for no reason and in the same way we healed randomly.
What is the plague?
The word "plague" has origins from the Indo-European word pes, mortal breath, which does not arise by chance since the spread of the disease is very rapid, as is the outcome of the same. The infected person dies within two, maximum six days and its spread is equally rapid. In a very short time, the entire population is, or can be hit, with a mortality that reaches as much as 70% of the infected.
Scientifically, plague is an infectious disease caused by the bacterium Yersinia pestis or Alexander Yersin's coconut bacillus, named after the French Swiss researcher who discovered it in Hong Kong in 1894 and isolated it. Before 1894 the disease was called black death, no one knew what caused it but everyone knew the fatal consequences.
Plague is a disease that affects rodents, rats, some species of squirrels, prairie dogs and the vehicle of transmission is the flea, a parasite that normally hosts these animals. As a rule, the plague bacterium circulates among these animals which represent long-term infectious reserves. At least one rodent has died of the plague in each outbreak of the disease. When fleas become infected, they suck the blood of their host to reproduce and survive, thus introducing the bacterium into the body and causing the animal's death. Once its host has died, the flea begins to search for a new living being, increasing the degree of contagion from "victim to victim". The optimal climatic conditions for the parasite's survival are spring and summer, with temperatures of at least 22-24 degrees and humidity of at least 60%. When the flea manages to infect the human being, the disease initially manifests itself with a banal fever and then turns, according to the type, into a bubo, comatose state, delirium, heart failure, inflammation of the spleen and kidneys, internal hemorrhage.
Being a bacterium, the contagion increases exponentially also through the touch of the infected parts: relatives and friends who give comfort to the sick, or people involved in transporting the sick to mass graves without due protection.
Three types of plague widespread in the past, which began in the same way and then changed during hospitalization:
- bubonic plague that presented a localized bump on the lymph nodes of the armpits, groin or neck, depending on the place where the flea had settled, often causing gangrene at the bite site, with very severe pain;
- pneumonic plague leading to breathing difficulties from primary pneumonia and possible choking from "blood outlet";
- septicemic plague that instead infected the blood, the rarest but lethal.
The last two types were the easiest to contract as they were transmitted through coughing or breathing.
Fortunately, if in ancient times the recovery or death of the person was left to chance, the study of the disease has improved over time and today the prognosis has significantly improved, thanks to antibiotic drugs. Isolation continues to be necessary to avoid the spread of the infection which is also associated with measures aimed at rodent control and the fight against fleas.
The plague in Venice
The first manifestation of the plague is traced back to 542 in Byzantium, while it arrived in Venice in 1348 from Dalmatia, by sea through merchant boats, transported by infected sailors who fled from Caffa, where the pandemic began, who mixed unconsciously among the population. Of the 110,000 inhabitants, some believe it infected and killed 37,000 people while others say the total is as high as 70,000. One can imagine how the phenomenon has completely destabilized social and economic relations, almost completely blocking relations between people, even between the closest relatives.
The Maggior Consiglio decided to face the emergency by appointing three experts, Nicola Venier, Marco Querini and Paolo Bellegni, to defend the health of the Venetians. First of all, they had the corpses moved to the city on two abandoned islands: San Leonardo di Fossamala and San Marco in Boccalama and, when these were insufficient, the deceased patients were moved to the islands of San Martino di Strada and Sant'Erasmo. The deceased in the campisanti in the city, normally reserved for the nobles, were buried under large quantities of earth.
Subsequently, the Maggior Consiglio initiated a series of measures to revive the economy, with tax relief for traders, ordering public officials to return to service regularly, encouraging immigration, restoring the processions and celebrations previously abolished due to the risk of contagion.
Authorization to leave the city (pardon), in the period of the plague (Wellcome Library, London)
However, the active precautionary measures - such as walling up the homes of the infected and closing entire areas of Venice - failed to be sufficient and effective to deal with the disease. The lagoon city could not give up trade, much less the patrician families who managed ambitious business in trade and possessed knowledge of geography, market, finance, customs and habits of the populations to which they arrived, adequate forms of communication and a flair for business.
This necessity made the nobles themselves among the most exposed and contagious people - and perhaps a little more imprudent than necessary - leading to the extinction of more than 50 Venetian patrician families after the pandemic of 1348.
After a succession of successive annual outbreaks, the second wave of pestilence occurred in Venice in 1423 and for three months the number of deaths was high every day, up to 40 deaths a day. Also in this case the disease was brought into the city by strangers who came from infected places, with the result that the sanitary maneuver implemented was to prohibit access to those who came from a infected place. The maneuver was so rigorous that those who still decided to host infected people despite the veto would have faced a penalty of 6 months in prison and the payment of a fine.
It was with the provision of the Senate of the Republic of 28 August 1423 that a special permanent hospital was provided for the first time, which later became called Lazzaretto. In addition to this hospital, in 1468, a second one was established, called Lazzaretto Nuovo.
Subsequently, there were two great waves of plague: that of 1576 and 1630.
Between 1 July 1575 and 28 February 1577, out of a number of about 180,000 people, about 50,000 died: the sick were stationed, until the end of their days or to recovery, in the Lazzaretto Vecchio while all those who had survived and those who had come into contact with infected people they had, as a precaution, to stay in the Lazzaretto Nuovo for a period of quarantine. Among the latter, there was also Francesco Sansovino who, due to illness, lost his 11-year-old daughter Aurora and his wife Benedetta.
The seventeenth-century epidemic that began in July 1630 and ended in October of the same year, also brought death and despair: in the historic center, out of just over 142,000 people, more than 46,400 died, not counting the approximately 46,000 deceased only in the islands of Malamocco, Murano and Chioggia.
In this circumstance, compared to the others, one can certainly blame the responsibility of bad management of the health of the Serenissima, or in any case of a flaw in it: the ambassador of the Duke of Mantua, Marquis De Strigis, came from the Mantua area where some outbreaks of plague which, contrary to all regulations, was not quarantined in the Lazzaretto Nuovo but on the island of San Clemente. As fate would have it, during a maintenance intervention in San Clemente the carpenter was infected and brought the terrible disease with him to the city. The aggravating circumstance was keeping the new epidemic hidden - to avoid the commercial isolation of Venice - thus causing a much greater contagion, which already with the knowledge of the time could have been avoided.
Fortunately, the pandemic of 1630 was the last of the Serenissima, thanks perhaps to the hard lesson given by the last infection and without doubts thanks to the efficient health management. Unfortunately this did not happen in several European cities and ports.
The Venetian lazarets
With the provision of the Senate of the Republic of 28 August 1423, a special permanent hospital was provided for the first time, a state structure that was always open and employed a director (prior or prior), one or two doctors and three women who helped doctors and who represented an intermediate form between orderly and nurse.
Given the lucrative salt market, the government charged the Ufficio del Sal, the judiciary responsible for collecting taxes on salt, with the financial burden of building the first hospital of the Venetians and the island of Santa Maria di Nazareth was chosen, which at the time it housed the convent of the Eremitani, as a physical place to erect it. The term Lazaret, then used throughout the West, seems to be the result of the popularization of the term Nazaretum. On January 1, 1424, the sanatorium was officially made operational and, since it was not easy to find personnel during the peaks of morbidity, religious were often used driven by piety and compassion, accepting to assist the sick.
This solution also made it possible to employ unpaid personnel, which is no small feat, especially in the most critical moments. In 1429, 80 rooms were set up for the hospitalization of the plague victims and, after only 60 years, an inventory of Nazareto robes drawn up in 1484 shows that the number of beds registered were 209. For reasons of space, initially, sick Venetians were mainly housed who had no domicile, to prevent them from wandering dangerously around the city, but when the endowments allowed it, the Lazaretto received plague victims of all social conditions, with or without domicile.
Authorization to leave the city (pardon), in the period of the plague (Wellcome Library, London)
In 1468, to further strengthen the prevention of the plague, it was decided to establish a second hospital using the spaces of the Vigna Murata island, located in front of Sant'Erasmo, which was renamed Lazzaretto Novo to distinguish it from the first. The construction of this health work was welcomed by the population with greater satisfaction than the Old One as this new hospital gave more hope to those who entered it to be able to return to the community of the healthy and survivors. On the island, as well as finding "refuge" for those who had come into contact with the sick but had no symptoms, ships also arrived from the Mediterranean and suspected of being carriers of the epidemic. The latter were quarantined on the island and an adequate sanitary system allowed the sanitation of the goods and the boats themselves through the use of aromatic herbs while the crew were housed in particular cells (rooms).
At the end of 1700, the Government of the Serenissima, not being able to use the Lazzaretti Vecchio and Nuovo due to their deterioration caused by the landfill of the surrounding waters, in 1782 established that the Lazzaretto Nuovissimo would be established on the island of Poveglia. Subsequently, for lack of funds, nothing was done. We began to talk about it again only in 1793, when a sailing boat infected by the plague, called tartana, arrived in Venice. The island of Poveglia was quickly equipped to respond to the emergency, erecting two wooden toll booths, one for the sick and one for the guardians and the whole island was fenced off with armed boats, containing the contagion (12 people died in all 'crew). Subsequently, the territory was used numerous times for absentia of infected crews and to stem outbreaks of plague, yellow fever and cholera. Starting from 12 October 1814, Poveglia was sold by the military to the Magistrate of Health, becoming a maritime health station.
The Italian lazarets
There were many Italian and foreign cities that followed the example of Venice.
First of all, Milan begins to worry about finding an effective solution to cope with epidemics, taking a cue from the work created in Venice. Thus it was that, between 1489 and 1509, the second Italian hospital was built in the area of Porta Orientale, immediately providing 280 rooms for the sick. The construction of the Lazaretto was providential in the face of the three great plague epidemics that struck Milan in 1524, 1576 and 1629.
Also in Lombardy, even in Bergamo the lazaretto was chosen as a form of disease prevention and approved in 1503 by the will of the Republic of Venice under which the Bergamo city was under, starting from the Peace of Ferrara in 1428. It was built not in the city but in the middle of the countryside, outside the circle of the Muraine, inside which there was a place of worship.
Third, in order of construction, is the Lazzaretto di Verona characterized by a particular architectural quality and elegance, as well as an unusual "modernity" for certain environments (inside the rooms, each patient could cook a hot dish and think about personal hygiene). It was erected on a vast loop of the Adige to house the sick and the "convalescents", divided by sex, reducing the risk of contagion to the maximum. The work is attributed to the architect Michele Sanmicheli even if it was completed after his death, exactly two years before the terrible plague of 1630.
As for Trieste, there were three hospitals that were built in defense of the city, starting from the eighteenth century, which was the historical moment in which at least one maritime hospital was planned in every main port of the European Mediterranean, starting from Marseille to Trieste. . Awareness of the maritime potential of the city of Trieste was certainly linked to Charles VI, who ascended the throne of Austria in 1711, transforming the city into a free port in just 8 years and increasing trade with the East. This opening then led to the construction of the first Trieste hospital in 1730, called “San Carlo”. Ten years later the new “Santa Teresa” Lazzaretto was inaugurated in 1769 to cope with the managerial insufficiency of the former. To make way for the railway station and the new port, in the San Bartolomeo di Muggia Valley, the new Lazzaretto was built, in use until the First World War.
Lazzaretti were also built in Ancona, La Spezia, Livorno and Porto Venere. Leaving the Italian territory, the lazzaretti will also find themselves in the Mediterranean and where the influence of their effectiveness was understood and implemented. In some places the remains of these lazarets are still present such as, for example, in Corfu.
One of the masks that is still used today at Carnival — the plague doctor — is one of the witnesses of those terrible epidemics.
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